Study to Look at Benefit of Surgical Drainage Before Beginning Medical Therapy for Crohns Perianal Fistulas
Summary
This study is looking at the advantage of establishing surgical drainage for Crohn's fistulas and abscesses prior to starting medical therapy.
Description
Currently the importance of surgically established drainage of Crohn's perianal fistulas prior to medical therapy is controversial. Several retrospective studies have suggested a benefit to this approach. (1, 2) However, there have been no prospective studies performed to answer this important question. This study aims to definitively answer this question. Our hypothesis is that by establishing surgical drainage of all perianal fistulas and abscesses prior to initiation of medical therapy, further abscess formation will be prevented and the rate of durable fistula healing will improve.
Study Design
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
Crohns Disease
Intervention
Surgically established drainage of perianal fistulas &/or abscesses BEFORE medical tx
Location
Vanderbilt University Medical Center
Nashville
Tennessee
United States
37232-1375
Status
Not yet recruiting
Source
Vanderbilt University
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT01145365
- Information obtained from ClinicalTrials.gov on July 15, 2010
Published on BioPortfolio: 2014-08-27T03:12:50-0400
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PubMed Articles
Most perianal abscesses have a cryptoglandular origin, following the pathogenesis described by Parks in 1961. Supralevator abscesses have the most uncommon location. Nevertheless, such pathology resul...
Presence of perianal fistulas in Crohn's disease (CD) denotes increased disease aggressiveness. We studied epidemiology and clinical outcomes of perianal CD (PCD) using Hong Kong territory-wide IBD Re...
Diagnostic Accuracy of 3-Dimensional Endoanal Ultrasound in Identifying Perianal Crohn's Fistulas.
Perianal fistulizing Crohn's disease is a challenging clinical situation that requires proper management. Some features seen on the endoanal ultrasound can be helpful in discriminating between cryptog...
Seton drainage in sphincter-sparing treatment of rectal fistulas.
Sphincter-sparing procedures for rectal fistulas are becoming more popular among coloproctologists. However, the outcomes are not optimal that forces surgeons to seek new approaches in order to improv...
Clinical updates on perianal fistulas in Crohn's disease.
Perianal fistulizing disease is an aggressive and debilitating phenotype of Crohn's disease (CD), representing a significant therapeutic challenge. New work has led to advancement in epidemiology and ...
Medical and Biotech [MESH] Definitions
Surgically-created Structures
Organs or parts of organs surgically formed from nearby tissue to function as substitutes for diseased or surgically removed tissue.
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Devices, usually incorporating unidirectional valves, which are surgically inserted in the sclera to maintain normal intraocular pressure.
Hidradenitis Suppurativa
A chronic suppurative and cicatricial disease of the apocrine glands occurring chiefly in the axillae in women and in the groin and anal regions in men. It is characterized by poral occlusion with secondary bacterial infection, evolving into abscesses which eventually rupture. As the disease becomes chronic, ulcers appear, sinus tracts enlarge, fistulas develop, and fibrosis and scarring become evident.
Medical Savings Accounts
Tax-exempt trusts or custodial accounts established by individuals with financial institutions for saving money for future medical expenses.
Fee Schedules
A listing of established professional service charges, for specified dental and medical procedures.
